Device and method for the guided removal of dental posts

ABSTRACT

A dental post removal device having a hollow tubular structure having a sidewall and distal and proximal open ends, an engaging feature positioned on insides of the sidewalls, and a fulcrum positioned on the hollow tubular structure adapted for pulling the hollow tubular structure and a dental post captured therein. The engaging features can be a series of openings formed through the sidewall of the hollow tubular structure, and/or the inner wall surfaces of the sidewall that is one of at least scored, textured, dimpled, coated with a high adhesion material or other type of surface preparation chemical, and/or internally threaded. The tubular structure is of generally constant outside diameter. The inner walls can either be of constant inner diameter, or can have an inner diameter that narrows from the distal end to the proximal end either continuously, or in discrete steps of increasingly smaller diameter.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation-in-part of U.S. patent applicationSer. No. 13/748,102, filed Jan. 23, 2013, entitled “Device and Methodfor Removing Dental Posts.”, which in turn claims priority from U.S.Provisional Patent Application No. 61/589,733, filed on Jan. 23, 2012,entitled “Device and Method for Removing Dental Posts.”

SUMMARY

The invention relates to the field of instruments and methods fordentistry, and more particularly to a device and method for the guidedremoval of dental posts used with dental crowns. In cases where theamount of the tooth's natural crown portion (the part of the tooth thatlies above the gum line) is insufficient, it may be necessary to buildthis area up. Reasons for lost crown include loss due to decay, fractureor being removed during root canal treatment. Dental posts may be metalposts that are cemented inside openings drilled into the tooth and areoften used as part of the build up process. The dental post provides away for the dentist to securely anchor the filling material core to thetooth. After the build up is concluded, a dental crown is placed tofinalize the restoration and to completely seal off the root canalspace.

While dental posts are useful in establishing dental restoration, it maybecome necessary to later remove the dental post, for example when thedental crown needs replacement or additional procedures need to beperformed on the tooth, such as carrying out further endodontictreatment. Since the dental post is often tightly cemented or bondedinto a tooth, and may not extend significantly above the gum line, itcan be difficult for a practitioner to use forceps or other dentalinstruments to grasp the post and remove it. Indeed, doing so may placeundue stresses and strains on tooth structure into which the post isimbedded and can possibly further damage the tooth. Furthermore, forcepsalone may not apply to the post the degree of force or the vector offorce required to safely dislodge many posts.

There accordingly remains a need for an improved device and method forthe guided removal of a metal dental post. The invention provides aguided dental post removal device and method. The device comprises atubular structure with a bore with side walls with an internal diameterand an external diameter. For the sake of this description, the tubularstructure is described as having an upper open end and a lower open end,where the upper open end describes the end which extends out of thetooth and the lower end describes the end which is inserted into thetooth. Since the tubular device can be used on a maxillary or uppertooth or on a mandibular or lower tooth the terms “upper” and “lower”should not be read to imply “up” and “down” orientations. A series ofopenings can be formed through the sidewalls of the tubular structure.The series of openings are preferably formed at different levels alongthe long axis of the tubular structure and at various angular positionsaround the perimeter of the tubular structure, and will act to allow aninfill material such as an auto-polymerizing composite resin, a cement,or other infill material to be filled into the tubular structure tomechanically connect to the tubular structure so that this infillmaterial and the dental post received therein will not twist or pull outof the tubular structure. In addition to or in lieu of the series ofopenings, the inside of the sidewalls can have inward or outwardprojections, can be scored, textured, indented and/or coated with a highadhesion material that will strongly adhere to the composite resin,cement or other material that will infill the tubular structure's bore.Likewise, internal threads can be formed on the inside of the sidewalls,which internal threads will assist in bonding with an auto-polymerizingcomposite resin, a cement, or other infill material injected in theinterior of the tubular structure and will also help engage with a filesuch as Hedstrom file inserted therein. As will be described furtherbelow, left handed threads may at times be beneficial becauseconventional Hedstrom files used with the tubular structure of theinvention are right handed spiraled, and as such, when a Hedstrom fileis screwed into the interior of the tubular structure, it willcross-thread with the left handed threads formed on the inside of thewalls of the tubular structure and thereby tend to engage better withthe tubular structure and the dental post to be removed, therebyproviding improved removal results. However, the internal threads can beright hand threaded in which case they will normally engage with a righthand threaded Hedstrom file or can be left hand threaded and be adaptedto engage with a specially designed left hand threaded Hedstrom file.

The tubular structure can include a collar or other fixing structurethat extends along the tubular structure and will be positioned foraccess by a pulling tool. The fixing structure is preferably at or nearthe upper end of the tubular structure. The fixture structure can be inthe nature of a collar that extends outwardly from the sidewalls of thetubular structure, can comprise a bulbous head that extends above theupper end of the tubular structure, can be an indent or groove formed inthe sidewall, can be an internally-threaded nut that screws onto threadson the outside of the tube, a screw that screws into an upper endtubular structure, or some other structure or mechanism that is adaptedto allow the fixing structure to be securely captured by a pulling tool.The fixture structure can be integrally formed with the tubularstructure, (e.g., by welding, adhesive, or mechanical attachment, suchas being crimped on), or the tubular structure and fixing structure canbe formed of a single piece of material, such as by being machined orcast, or it can be attached via threads. In embodiment, instead of astationary fixing structure, such as a collar, the device can include amovable fulcrum having a female threaded through hole formedtherethrough, which movable fulcrum is designed to threadably engagewith external male threads formed on the outside wall of the upperportion of tubular structure with the movable fulcrum being adapted tobe threaded towards the unthreaded lower portion of the tubularstructure during use, as will be described below.

Metallic dental posts come in various lengths and outer diameters, andto accommodate the various dental posts, a series of different sizeddental post removal devices with varying lengths and internal diametersof the tubular structure will be provided.

The dental post will have been previously prepared as follows. First,any build up material that was formed around the dental post will beremoved, such as by a dental drill or ultrasonic tip. For example, a #½or #¼ deep dental bur will be used to dissect cement from around thedental post. Once the dental post is free from build up material, then aseries of generally horizontal notches or grooves will be formed alongdifferent levels and angular positions of the outer sidewall of thedental post. This can be accomplished with a wheel bur, such as offeredby Brasseler USA, or other dental instruments. To avoid unduly weakeningthe integrity of the dental post, such that it might snap off when beingremoved, the notches should not extend too deeply into the walls of thedental post, and should not completely circumnavigate the dental post.After the dental post is prepared, it should be cleaned and dried. Ifdesired, it may also be coated with an accelerator or other type ofsurface preparation chemical which can enhance the adhesion of thematerial such as an auto-polymerizing composite resin, cement, or othermaterial to the post.

The practitioner will then select the most ideally sized dental postremoval device to accommodate the dental post. It may be preferable thatthe wall structure of the dental post removal device be formed of adeadsoft material so that it can be adjusted (e.g., bent) to easily fitonto the dental post. Before proceeding, the practitioner should trialfit the dental post removal device onto the dental post in order toensure that it fits well and to ensure that the dental post removaldevice can be quickly engaged with the dental post once the dental postremoval device is charged with composite, cement or other material. Anaggressively-fluted endodontic file (such as a Hedstrom file) ofappropriate length and diameter is then selected, inserted through theopen end of the tube, and test-threaded clockwise into the tube, tightlysecuring itself against the lumen of the tube while becoming engagedinto notches on the prepared post. This file is then removed and setaside for later re-insertion. Likewise, the tube of the dental postremoval device is also removed in order to prepare it for the next step.

A high strength and fast curing composite resin, cement or other infillmaterial will be injected (e.g., with a syringe) into the lower openedend of the tubular structure and fill it until the infill material exitsthe opposite opened end of the tubular structure. An example of anexcellent infill material for this purpose includes RapidCore® fromCentrix®; however, other high strength composite resins or cements formetal to metal adhesion or other materials can be used. If composite isused, it must be an auto-polymerizing type of composite becauselight-initiated polymerization is ineffective when the material iswithin the tubular structure of the device. The RapidCore® compositeresin will begin to set up immediately and cures in as little as twominutes. Once the composite resin, cement or other infill material isintroduced into the interior of the tubular structure, a finger or thumbis placed over the open end of the tube to prevent the material frombeing forced out the open end of the tube, the tube is quickly fittedover the dental post which has been prepared, and the prior-fittedaggressively-fluted file is immediately re-inserted into the open end ofthe tube and clockwise rotated to mechanically secure it within the tubealongside the prepared post. The infill material is allowed to set orpolymerize undisturbed. On insertion of the tube onto the post, anyinfill material that is forced out through any openings formed in thesidewalls of the tubular structure will not adversely affect theoperation of the device. The infill material will fill in the space inthe interior of the tubular structure around the dental post with itsgrooves or notches formed thereon and adhere to any inward or outwardprojections, interior scoring, texturing, threads, and/or coating of thesidewalls and lock into the series of any openings formed through thesidewalls of the tubular structure. Thus, the material will effectivelylock the dental post together with the tubular structure of the dentalpost removal device. This will allow a dental post that is tightlycemented or bonded to a tooth to be safely removed.

After adhesion of the device of the invention to themechanically-secured file and post, an expansion plier, such as amodified version of a Ruddle Post Remover tool, the Gonon Post Removertool, the Thomas Post Remover tool, the Easy X-TRACTOR (A-TitanInstruments), the UPR (Universal Post Remover-Dent Corp), the Outpost(San Diego Swiss Machining) or another similar device, is used togradually pull outwardly on the dental post removal device and itsattached file and dental post. The expansion pliers can be designed toinclude at its moving end, a catch for engaging the stationary fixingstructure or movable fulcrum of the dental post removal device. To bemore effective for removal of threaded posts, this pulling device mayalso be developed in such a way as to apply selectively a rotationalforce during the extraction process which rotational force may be eitherclockwise or counter-clockwise and may also be de-selected. Regardingthe matter of a rotational force selectively applied during theextraction process, if such rotational force were to becounter-clockwise in order to “unscrew” a clockwise-threaded post, thenthe Hedstrom file should be left-hand fluted so as not to unscrew itselfduring the counter-rotation of the apparatus during operation. Astationary end of the expansion pliers will be supported on the toothfrom which the dental post is being removed. A rubber “insulator” istypically included with the Ruddle device and other similar devices. Theinsulator provides an interface between the “stationary end” of theRuddle pliers and the tooth structure on which it will rest whenapplied.

Another methodology that the inventor uses to off-lay some of thepotentially damaging force that can be generated on the cusp tips ofcompromised tooth structure is as follows. The inventor places a hollowplastic cone over the exposed post with the larger diameter of the coneextending outward from the tooth, and then injects a non-bondedauto-polymerizing composite or similar material in the space around theoutside of conical tube to fill the cavity space up to the occlusalsurface of the tooth and beyond, covering all delicate coronalstructure. On polymerization (or setting if not a composite), theplastic cone is removed, and the surface of the material is flattened.This flattened surface provides a robust platform against which to restthat portion of the expansion pliers. The advantage of this over theinsulator is that it distributes the considerable force of the pliersthroughout the entire coronal structure of the tooth, and not justagainst the high points of the cusp tips or the perimeter of the cavitypreparation as does the rubber insulator. Since the material is notbonded into the tooth, but is only injected passively into the cavityand over the coronal perimeter, after the post is removed, the materialis easily removed with dental burs or sometimes with only a simpleslight nudge from a hand instrument. The expansion pliers areaccordingly used to apply a pulling force to the dental post and removeit from the tooth. The expansion pliers generates considerablemechanical advantage and includes a screw knurl, which when turned,provides the pulling force. Other pulling types of tools can be usedwith the pulling force being preferably generated along the same axis asthe dental post being removed.

As noted above, the dental post removal device can be provided as aseries of different tubular structures with parallel or generallyparallel side walls having inner and outer diameters to accommodatedifferent sized dental posts. In lieu of providing such a series ofdifferent sized tubes of uniform inner and outer diameter, the inventionalso contemplates providing a dental post removal device with agenerally conical-shaped tubular structure with a narrower open end thatwidens as it progresses upwardly towards either an opened or a closedend. In such an embodiment, the walls can be of uniform thickness sothat the lumen passing therethrough will be conical and the outer shapewill also be generally conical. Alternately, the outer diameter canremain constant while only the inner lumen is conical, in which case thewall thickness will vary. When the wider end is open, it accommodatesthe insertion of a Hedstrom file. The standard Hedstrom file has a 02taper, so providing a slight internal flare of this version of the postremoval device-for example a 04 taper-would facilitate a tightadaptation of the 02-tapered file to the flare/taper of the inner wallof the device. With this embodiment, if the dental post is of a largerdiameter than the open end of the generally conical-shaped tubularstructure, the practitioner can cut off a section of the tubularstructure so that the open end is large enough to receive the dentalpost. The end can be cut off with a wheel saw or other commonlyavailable dental instruments. One feature of this embodiment, besidesnot needing to provide a series of dental post removal devices withdifferent sized tubular structures, is that as a pulling force isexerted on the dental post removal device, the mass of composite, cementor other material formed inside the conical shaped tubular structurearound the dental post will be generally frustum conical in shape andwill accordingly not be able to pull through the smaller opening.

As a result of using the dental post removal devices and method of theinvention, dental posts that are stubbornly affixed in a tooth, even indifficult to access locations, can be reliably removed while minimizingpotential stress to the remaining tooth structure to which the dentalpost is affixed and surrounding teeth and tissue.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a front view of an exemplary embodiment of a dental postremoval device of the invention.

FIG. 2 is a longitudinal cross-sectional view of the dental post removaldevice of FIG. 1.

FIG. 3 is a detail showing an exemplary embodiment of another dentalpost removal device of the invention.

FIG. 4 is a detail showing yet another exemplary embodiment of a dentalpost removal device of the invention.

FIG. 5 is a longitudinal cross-sectional view showing a furtherexemplary embodiment of a dental post removal device of the invention.

FIG. 6 is a diagrammatic view showing a tooth with a dental post and adental crown before the dental post is exposed.

FIG. 7 is a diagrammatic view showing a tooth with a dental crownremoved and with tooth structure partially removed around the dentalpost to partially expose the dental post.

FIG. 8 is a diagrammatic view showing the dental post after it isnotched.

FIG. 9a is a diagrammatic view showing the notched dental post with adental post removal device slid on over the dental post, and withcomposite resin, cement or other material filling the space in thedental post removal device around the dental post to secure the dentalpost removal device and the dental post together, just prior to beingremoved together from the tooth.

FIG. 9b is a diagrammatic view showing the tooth, post and device ofFIG. 9a just prior to the setting of the composite with a Hedstrom fileinserted through the open end to the point where it has engaged thenotched post and thereafter been right-hand rotated with inward pressureso as to fully lodge itself between the post and the wall of the dentalpost removal device, thus adding significantly to the “adhesion” of the4-element device (tube, composite, post, and now Hedstrom file).

FIG. 10 is a side view of a Ruddle post pulling tool used with thedental post removal device of the invention.

FIG. 11A is a front view of another exemplary embodiment of a tubularstructure of a dental post removal device of the invention.

FIG. 11B is a front view of yet another exemplary embodiment of atubular structure of a dental post removal device of the invention.

FIG. 12A is a front view of the exemplary embodiment of the tubularstructure of FIG. 11A engaged with a movable fulcrum.

FIG. 12B is a front view of the exemplary embodiment of the tubularstructure of FIG. 11B engaged with a movable fulcrum.

FIG. 13 is a detail isometric view showing the exemplary movablefulcrum.

FIG. 14 is a back view of the movable fulcrum.

FIG. 15 is a front view of the movable fulcrum.

FIG. 16 is an isometric view showing internal threads formed in theinner sidewalls of the tubular structure.

FIG. 17A is a cross-section view of the tubular structure of FIG. 16.

FIG. 17B is a cross-section view of the tubular structure having alongitudinal groove formed on the inside of the sidewall.

FIG. 17C is a cross-section view of the tubular structure having a pairof spaced apart longitudinal beads formed on the inside of the sidewall.

FIG. 18 is an isometric detail view showing the movable fulcrum on thetubular structure engaged with a pulling tool prior to the movablefulcrum being screwed down onto the pulling tool.

FIG. 19 is an isometric detail view showing the movable fulcrum on thetubular structure engaged with a pulling tool with the movable fulcrumscrewed down nearly onto the pulling tool.

FIG. 20 is an isometric detail view showing the movable fulcrum on thetubular structure engaged with a pulling tool with the pulling toolpartially activated to partially lift the tubular structure.

FIG. 21 is an isometric detail view showing the movable fulcrum on thetubular structure engaged with a pulling tool with the pulling toolfurther activated to further lift the tubular structure.

FIG. 22 is a cross-sectional view of another embodiment of acontinuously internally tapered tubular structure of a dental postremoval device of the invention.

FIG. 23 is a cross-sectional view of yet another embodiment of agraduated parallel sided internally stepped tubular structure of adental post removal device of the invention.

DETAILED DESCRIPTION

FIG. 1 is a front view of an exemplary embodiment of a dental postremoval device 10 of the invention and FIG. 2 is a longitudinalcross-sectional view thereof. The dental post removal device 10 includesa tubular structure 12 with sidewalls 13 with an outer surface 14 and aninner surface 16. The tubular structure 12 has two open ends, 18 and 20and has a bore 28 running therethrough. A series of through holes oropenings 22 are preferably formed through the tubular structure 12. Thetubular structure 12 will preferably have sidewalls 13 consisting ofparallel side walls and will be formed of strong metal. The metal can benon-pliable, or pliable. In addition to metal, the tubular structure canbe formed of other materials such as composite materials includingpara-aramid synthetic fiber. The series of openings 22 are preferably atdifferent vertical levels along the long axis of the tube 12 and atdifferent angular positions around the circumference. The series ofopenings 22 will act to allow composite resin, cement or other materialto be filled into the bore 28 of the tubular structure 12 tomechanically connect to the tubular structure 12 so that, uponpolymerizing, setting or curing, the composite resin, cement or othermaterial and the dental post received therein (see FIGS. 9a and 9b )will not twist or pull out of the tubular structure 12. In addition toor in lieu of the series of openings 22, the inner surface 16 of thesidewalls 13 can be scored, textured, and/or coated with a high adhesionmaterial 24 or other type of surface preparation chemical which canenhance the adhesion of a composite resin, cement or other material.Likewise, rather than including a series of openings formed in the tubeor having the inside of the tube scored, textured, and/or coated with ahigh adhesion material or other type of surface preparation chemicalwhich can enhance the adhesion, the tubular structure 12 can havedimples (not shown) formed on the inner surface 16 of the sidewalls 13.These structural features are referred to herein as “engaging features.”The tubular structure 12 further includes a collar or other fixingstructure 26 that extends outwardly from the tubular structure and willbe positioned for access by a pulling tool. The fixing structure 26 ispreferably at or near end 20 of the tubular structure 12. The fixturestructure 26 can be in the nature of a collar that extends outwardlyfrom the sidewalls of the tubular structure.

Alternatively, as shown in FIG. 3, a dental post removal device 40 caninclude as a fixing structure a bulbous head 44 contiguous with anarrower neck 46 that is contiguous on its opposite side with a tubularstructure 42; or, as shown in FIG. 4, a dental post removal device 50can comprise an indent 54 formed in the tubular structure 52 contiguouswith a wider end 56 on its opposite side. Other fixing structures thatare adapted to allow the fixing structure to be securely captured by apulling tool can also be used, such as indent(s) or groove(s) formed inthe sidewall, an internally-threaded nut that screws onto threads on theoutside of the tube, a screw that screws into an upper end tubularstructure, or some other structure or mechanism that is adapted to allowthe fixing structure to be securely captured by a pulling tool. Thefixture structure can be integrally formed with the tubular structure,(e.g., by welding, adhesive, or mechanical attachment, such as beingcrimped on), or the tubular structure and fixing structure can be formedof a single piece of material, such as by being machined or cast, or itcan be attached via threads. Whatever embodiment of fixture structureused, it can be integrally formed with the tubular structure, (e.g., bywelding, adhesive, mechanical attachment such as being crimped on),detachably screwed on, or the tubular structure and fixing structure canbe formed of a single piece of material. The tubular structure can, ifdesired, be formed of deadsoft material that can be formed (e.g. bent)to accommodate the needs of the practitioner. A series of the dentalpost removal devices 10, 40, 50 can be provided having different gaugetubular structures to best fit different sized dental post to beremoved.

FIG. 5 is a longitudinal cross-sectional view showing a furtherexemplary embodiment of a dental post removal device 60. In lieu ofproviding a series of different sized tubular structures, the inventionalso contemplates providing a dental post removal device 60 with agenerally conically-shaped tubular structure 62 with a narrower open end70 that widens as it progresses in its long axis towards the oppositeend 72. The conically-shaped tubular structure 62 has an outer surface64 and an inner surface 66. A series of openings 68 may be formedthrough the conically-shaped tubular structure 62. A collar or otherfixing structure 74 that extends outwardly from the tubular structure 62will be provided for engagement with a pulling tool. The fixingstructure 74 is preferably located at or near the wider end 72 of thedevice 60. Although the tubular structure 62 is shown as having asignificant taper, it need only be slightly tapered. The fixturestructure 74 can be in the nature of a collar that extends outwardlyfrom the sidewalls of the tubular structure. Alternatively, it can be abulbous head or an indent formed on the body of the device (similar toFIGS. 3 and 4.) With this particular embodiment of the dental postremoval device 60, if the diameter of the dental post is larger than theopen end 70 of the conically-shaped tubular structure 62, thepractitioner can cut off a section of the smaller-diameter end of theconical structure 62 so that the newly created open end 70 is largeenough to receive the dental post. The end can be cut off with a wheelsaw or other commonly available dental instruments. Besides not needingto provide a series of dental post removal devices with different sizedtubular structures, this embodiment has an additional benefit. Since themass of cement formed inside the conically-shaped tubular structurearound the dental post will be generally frustum conical in shape, itwill not be able to pull through the smaller opening as a pulling forceis exerted on the dental post removal device.

FIG. 6 is a diagrammatic view showing a tooth T with a dental post DPand a dental crown DC before the dental post DP is exposed. As shown,the tooth T is located between two other teeth T₁ and T₂.

FIG. 7 is a diagrammatic view showing a tooth T with a dental crown DCremoved and with the tooth structure partially removed to form a cavityO around the dental post P to partially expose the dental post DP. ToothT is shown between teeth T₁ and T₂.

FIG. 8 is a diagrammatic view showing the dental post DP after beingprepared by having a series of grooves or notches cut into itssidewalls. The dental post DP will have been previously prepared asfollows. First, any build up material that was formed around the dentalpost DP will be removed, such as by a dental drill or ultrasonic tip,and a cavity O may be formed in the tooth T around the dental post DP ifnecessary in order to expose the post adequately. For example, a #½ or#¼ Munce Discovery Bur Deep Trougher will be used to dissect cement fromaround the dental post DP. Once the dental post DP is free from build upmaterial, cement and encroaching tooth structure, then a series ofgenerally horizontal notches or grooves G will be formed along differentlevels and angular positions around the outer sidewall of the dentalpost DP. This can be accomplished with a wheel bur, such as offered byBrasseler USA, or other dental instruments. To avoid unduly weakeningthe integrity of the dental post DP, such that it might snap off whenbeing removed, in cases where the post is of a relatively smalldiameter, the notches or grooves G should not extend too deeply into thewalls of the dental post DP, and preferably nor should the notches beformed all the way around to form a collar groove on the dental post DP.After the dental post DP is prepared, it should be cleaned and dried. Ifdesired, it may also be coated with an accelerator which can enhance theadhesion of the material such as an auto-polymerizing composite resin,cement, or other material to the post.

The practitioner will then select the most ideally sized dental postremoval device to accommodate the dental post DP. It may be preferablethat the wall structure of the dental post removal device be formed of adeadsoft material so that it can be adjusted (e.g., bent) to easily fitonto the dental post. Before proceeding, the practitioner should trialfit the dental post removal device onto the dental post in order toensure that it fits well and to ensure that the dental post removaldevice can be quickly engaged with the dental post once the dental postremoval device is charged with composite resin, cement or othermaterial. While the device remains trial-fitted on the post, a Hedstromfile is trial-inserted through the open end to the point where it hasengaged the notched post and thereafter been right-hand rotated withinward pressure so as to fully ensure that it will fully lodge itselfbetween the post and the wall of the tube. Once the properly-sizedHedstrom file has been selected and trial-inserted as above, the file isremoved and set aside.

Next, in order to use the dental post removal device 10, 40, 50, 60 ofthe invention, a high strength and fast polymerizing composite resin,cement or other material C (see FIG. 9a ) will steadily be injected(e.g., with a syringe) into one of the open ends 18 or 20 of the tubularstructure 12, while withdrawing the injecting end of the syringe fromthe tube. This is done until the material C has completely filled thetube and has begun to exit the series of openings 22 formed through thesidewalls of the tubular structure 12 and also exits the opposite openedend of the tubular structure 12. Any excess material may be removedbefore it cures, sets or polymerizes. An acceptable material for thispurpose includes RapidCore® composite from Centrix®; however, other highstrength composite resins, cements or other materials for metal to metaladhesion can be used. The RapidCore® composite will begin to set upimmediately and polymerizes in as little as two minutes. Once thematerial C is introduced into the interior of the tubular structure 12and any excess material is removed, the tubular structure 12 is quicklyfitted over the dental post DP which has been prepared. The selectedHedstrom file is then immediately inserted through the open end of thetube to the level where it begins to engage the prepared post and thenright-hand rotated so as to be threaded into the tube fully engagingitself between the post and the wall of the tube. Speed is importanthere because of the polymerization or setting process of the materialwhich will already be underway. The material inside the device isallowed to polymerize, set or cure undisturbed, affixing each element ofthe multi-part device into a single unit. Once set, cured orpolymerized, any additional material C that has been pushed out of thechannel formed in the tubular structure by the dental post DP throughthe openings 22 formed in the sidewalls of the tubular structure 12, canbe removed, if desired, with an instrument, so that it does not extendinto cavity O formed in the tooth T around the dental post DP. However,removing these excess “bullets” of material is not really required, butif it does take place, it should only be done after the materialcompletely sets or polymerizes. The composite resin, cement or othermaterial C will fill in the space in the interior of the tubularstructure around the dental post DP with its grooves or notches G formedthereon as well as around the flutes on the engaged Hedstrom file andadhere to any interior scoring, texturing, and/coating of the sidewalls,or other engaging features (e.g., internal dimples) of the tubularstructure, and lock into the series of openings 22 formed through thesidewalls of the tubular structure. Thus, the material C willeffectively permanently lock the dental post DP and the Hedstrom filetogether with the tubular structure 12 of the dental post removal device10. This will allow a dental post DP that is tightly cemented or bondedin place in a tooth to be safely removed.

FIG. 9A is a diagrammatic view showing the notched dental post DP with adental post removal device 10 slid on over the dental post DP and withdental composite resin, cement or other material C filling the space inthe dental post remover tool around the dental post DP and extendinginto the openings 22 formed in the sidewalls of the dental post removaldevice 10 to secure the dental post remover tool and the dental post DPtogether, just prior to being removed together from the tooth.

FIG. 9B is a diagrammatic view showing the tooth, post and device ofFIG. 9a just prior to the setting of the composite with a Hedstrom fileH inserted through the open end to the point where it has engaged thenotched post and thereafter been right-hand rotated with inward pressureso as to fully lodge itself between the post and the wall of the tube,thus adding significantly to the “adhesion” of the 4-element device(tube, composite, post, and now Hedstrom file).

FIG. 10 is a side view of a Ruddle post remover tool 90, a pullingdevice used with the dental post remover tool of the invention. TheRuddle post remover tool 90 has a dental post removal tool engaginglever portion R₁ and a tooth engaging lever portion R₂. The dental postremoval tool engaging lever portion R₁ has a dental post removal toolengaging end 80 and the tooth engaging lever portion R₂ has a toothcontact end 82 at a distal end 84 of the device. A knurl 86 ispositioned on a threaded shaft 88 near a proximal end 92 of the devicewhich passes through the dental post removal tool engaging lever portionR₁ and the tooth engaging lever portion R₂. By rotating the knurl 86 ina clockwise direction this brings the two proximal ends closer and movesthe two distal ends apart from each other. The dental post pulling toolengaging lever portion R₁ and the tooth engaging lever portion R₂ arepivoted together by a pivot 94 that is closer to the distal end 84 thanthe proximal end 92, and can accordingly generate considerablemechanical advantage. After adhesion is established, an extraction tool,such as a modified version of a Ruddle post pulling tool, is used togradually pull outwardly on the dental post removal device and itsattached dental post. The Ruddle post pulling tool can include at itsmoving end a catch for engaging the fixing structures 26, 44, 54, 74 ofthe dental post removal devices 10, 40, 50, 60, respectively. The distalend of the Ruddle post pulling tool's tooth engaging lever portion R₂will be supported on the tooth T from which the dental post DP is beingremoved and the distal end of dental post removal tool engaging leverportion R₁ will be engaged with the fixing structure 26, 44, 54, 74 ofthe dental post removal device 10, 40, 50, 60, respectively. By rotatingthe knurl 86 in a clockwise direction, a force F will pivot the dentalpost pulling tool engaging end 80, causing it to pull its attacheddental post DP out of the tooth T. In practice, once the adhesionbetween the dental post DP and the tooth T to which it is affixed isbroken, the dental post DP can generally be easily withdrawn.

Turning to FIGS. 11-21, there are shown views of another embodiment of athreaded hollow tubular structure 100 for the guided removal of dentalposts (as shown in FIG. 8.)

FIG. 11A is a front view the exemplary embodiment of the tubularstructure 100 of a dental post removal device of the invention 120 whichis shown with its movable fulcrum 122 attached to the tubular structure100 in FIG. 12A. As shown, the hollow tubular structure 100 has aproximal region 102, and a distal externally threaded region 104 withmale threads 106 formed thereon. The proximal region 102 is shown ashaving a series of optional peripheral holes 108 formed through thesidewall 110 thereof. These optional peripheral holes 108 will help toretain infill material to be injected into the hollow tubular structure100 in the same manner as discussed with the dental post removal device10 of FIGS. 1-9B above. However, in addition to or in lieu of the seriesof holes 108, the inside of the sidewalls 110 can have inward or outwardprojections, can be scored, textured, indented and/or coated with a highadhesion material or other type of surface preparation chemical whichcan enhance the adhesion of composite resin, cement or other materialthat will infill the tubular structure's bore, and best yet, can haveinternal threads formed thereon. Use of internal threads formed on theinside of the sidewalls will assist in bonding with cement injected inthe interior of the tubular structure and engage with the Hedstrom file.Left handed threads can sometimes be useful because Hedstrom files usedwith the tubular structure of the invention are right hand spiraled, andas such, when a Hedstrom file is screwed into the interior of thetubular structure, it will cross-thread with the left handed threadsformed on the inside of the walls of the tubular structure and therebytend to engage better with the tubular structure and the dental post tobe removed, thereby providing improved engagement of the tubularstructure, the dental post, and the Hedstrom file, and better removalresults. However, right hand internal threads and right hand threads onthe Hedstrom file or left hand internal threads and a Hedstrom file withleft handed threads could provide a better lock between the Hedstrom andinner threads. Left handed internal threads could be useful, however, inthe case of a threaded post that is being removed because a threadedpost will virtually always be right hand threaded, and so left handthreads inside the tube would definitely be preferred to allow lefthanded rotation of the tube without unscrewing the tube from the innerthreads—in fact, rotating in the left hand direction would “tighten” thecomposite on the threads while at the same time putting an unscrewingrotation onto the target threaded post. The tubular structure 100 has aproximal end 112 and a distant end 114. The distal end 114 is shown asbeing mushroomed out so as to prevent the movable fulcrum 122 from beingremoved from the distal end 114. The length of the distal externallythreaded region 104 with male threads 106 is preferably long enough toallow the movable fulcrum 122 to be moved a substantial distance D alongthe externally threaded region 104 by turning the movable fulcrum 122.The movable fulcrum 122 preferably has a grasping region, such as aknurled rim 124, and a front region 126 that will impinge on the dentalpost pulling tool engaging end 80 as described further below regardingFIGS. 18-20. The movable fulcrum 122 will be screwed onto the externallythreaded region 104 by a user, e.g., a dentist, who grasps and turns theknurled rim 124 to bring the movable fulcrum 122 closer to the open endof the tubular structure 100 that captures the dental post.

FIG. 11B is a front view yet another exemplary embodiment of a tubularstructure 200 of a dental post removal device of the invention 220 whichis shown with its movable fulcrum 222 attached to the tubular structure200 in FIG. 12B. As shown, the hollow tubular structure 200 has aproximal region 202, and a distal externally threaded region 204 withmale threads 206 formed thereon. The proximal region 202 is shown ashaving a series of optional peripheral holes 208 formed through thesidewall 210 thereof. These optional peripheral holes 208 will help toretain infill material to be injected into the hollow tubular structure200 in the same manner as discussed with the dental post removal device10 of FIGS. 1-9B above. However, in addition to or in lieu of the seriesof holes 208, the inside of the sidewalls 210 can have inward or outwardprojections, can be scored, textured, indented and/or coated with a highadhesion material or other type of surface preparation chemical whichcan enhance the adhesion of composite resin, cement or other materialthat will infill the tubular structure's bore, and best yet, can haveinternal threads formed thereon. Use of internal threads formed on theinside of the sidewalls will assist in bonding with composite resin,cement or other material injected in the interior of the tubularstructure and engage with the Hedstrom file. Left handed threads cansometimes be useful because Hedstrom files used with the tubularstructure of the invention are right hand fluted, and as such, when aHedstrom file is screwed into the interior of the tubular structure, itwill cross-thread with the left handed threads formed on the inside ofthe walls of the tubular structure and thereby tend to engage betterwith the tubular structure and the dental post to be removed, therebyproviding improved engagement of the tubular structure, the dental post,and the Hedstrom file, and better removal results. However, right handinternal threads and right hand threads on the Hedstrom file or lefthand internal threads and a Hedstrom file with left handed threads couldprovide a better lock between the Hedstrom and inner threads. Lefthanded internal threads could be useful, however, in the case if athreaded post that is being removed because a threaded post willvirtually always be right hand threaded, and so left hand threads insidethe tube would definitely be preferred to allow left handed rotation ofthe tube without unscrewing the tube from the inner threads—in fact,rotating in the left hand direction would “tighten” the composite on thethreads while at the same time putting an unscrewing rotation onto thetarget threaded post. The tubular structure 200 has a proximal end 212and a distant end 214. Located at the distal end 214 is an enlarged ring228 which has a frontward seat 230 which will prevent the movablefulcrum 122 from being screwed completely off the distal end 214 of thetubular structure 200. The enlarged ring 228 can be formed together withthe tubular structure 200 or can be in the form of a nut that ispermanently affixed to the end of the tubular structure 200. The lengthof the distal externally threaded region 204 with male threads 206 ispreferably long enough to allow the movable fulcrum 222 to be moved asubstantial distance D along the externally threaded region 204 byturning the movable fulcrum 222. The movable fulcrum 222 preferably hasa grasping region, such as a knurled rim 224, and a front region 226that will impinge on the dental post pulling tool engaging end 80 asdescribed further below regarding FIGS. 18-20. The movable fulcrum 222will be screwed onto the externally threaded region 204 with its frontregion 226 facing the proximal region 202 by a user, e.g., a dentist,who grasps and turns the knurled rim 224 to bring the movable fulcrum222 closer to the open end 212 of the tubular structure 200 into whichthe dental post is captured.

FIG. 13 is a detail isometric view showing the movable fulcrum 122, itsknurled rim 124 and its front region 126. The front region 126 can havea domed shape 128. A back end 130 is shown with a threaded through hole132 formed axially through the moving fulcrum 122 and exits at its frontregion 126. As shown, the through hole 132 widens out at its very endand acts to prevent removal of the movable fulcrum 122 from the tubularstructure 100.

FIG. 14 is a back view of the movable fulcrum 122 and shows its back end130 and its threaded through hole 132.

FIG. 15 is a front view of the movable fulcrum 122 and shows its knurledrim 124, its preferably domed structure 128 and the front region 126,and the threaded through hole 132.

FIG. 16 is an isometric view showing a portion of the proximal end 102of the tubular structure 100, and shows internal threads 140 formed onthe inside of the sidewalls 110 thereof. As noted above, the internalthreads 140 could be right-hand or left-hand threads. The hollowinterior 142 defined by the sidewall 110 is adapted to receive infillmaterial, the dental post to be removed, and a dental tool, such as aHedstrom file in the same manner as described with respect to FIG. 9Babove. Also shown is one of the optional peripheral holes 108.

FIG. 17A is a cross-section view of the tubular structure 100A of FIG.16, and shows its sidewalls 110 and internal threads 140 formed on theinsides of the sidewalls. The hollow interior 142 defined by thesidewall 110 is shown.

FIG. 17B is a cross-section view of another tubular structure 100Bhaving a longitudinal groove 150 formed on the inside of the sidewall110. The longitudinal groove 150 is preferably formed along the entirelength of the tubular structure 110 and is preferably a straight groove.While the groove 150 is shown as being generally rectangular incross-section, it can have other profiles, such as being a V-shapedgroove, a rounded bottom groove, or have other shapes. The groove 150will be useful as it will tend to guide the Hedstrom file (not shown)when it is inserted into the hollow interior 142 defined by the sidewall110.

FIG. 17C is a cross-section view of the tubular structure 100C having apair of spaced apart longitudinal beads 160A and 160B formed on theinside of the sidewall 110. Between the two spaced apart longitudinalbeads 160A and 160B an elongate region 162 is created that will act as aguide to direct movement of a dental tool, such as a Hedstrom file, whenthe tool is inserted into the hollow interior 142 defined by thesidewall 110. However, either of the outer side edges 164A and 164B ofthe longitudinal beads 160A and 160B, respectively, can function to helpguide the Hedstrom file (not shown.) Although two longitudinal beads160A and 160B are shown, it is possible to only have one longitudinalbead. Moreover, the shape of the bead can be altered as desired, and canbe formed during the process of extruding the tubular structure, or canbe affixed thereto.

FIG. 18 is an isometric detail view showing the movable fulcrum 122partially screwed onto the distal externally threaded region 104 of thetubular structure 100, with the tubular structure 100 engaged with apulling tool prior to the movable fulcrum 122 being screwed down onto adental post pulling tool engaging end 80 of post remover tool 90, whichengaging end 80 rests on a tooth T.

FIG. 19 is an isometric detail view showing the movable fulcrum 122after being screwed down nearly all the way to where its front region126 impinges on the dental post pulling tool engaging end 80 of postremover tool 90. When truly seated into the depression on the upperelement of the Ruddle plier, there will be intimate contact between theglobal end of the nut and the depression.

Referring also to FIG. 10, for example, in this state, when the dentalpost pulling tool 90 is operated to raise dental post removal toolengaging end 80 from the tooth contact end 82 thereof (as shown in FIGS.20 and 21), a substantially upward force will also immediately act onthe movable fulcrum 122 and its connected tubular structure 100 and thedental post engaged therewith (not shown). FIG. 20 shows the dental postpulling tool engaging end 80 and the tooth contact end 82 separated byan angle α, and FIG. 21 shows the dental post pulling tool engaging end80 and the tooth contact end 82 separated further by an angle β, whereangle α is less than angle β. At relatively small angles α and β, thepulling force F will almost exclusively consist of an upward forcecomponent, but as the angle becomes larger, there is more of a sideforce that would tend to pull perpendicular to the direction of thepost. In order to keep the angles α and β relatively small, during theprocess of removing a dental post, the user can activate the pullingtool 90 by operating its knurl 86, the dental post removal tool engagingend 80 and the tooth contact end 82 will be moved apart from each otherby a certain distance and angled apart from each other. To prevent theneed to increase the angle, the user can turn the knurl 86 in anopposition direction to bring the dental post removal tool engaging end80 and the tooth contact end 82 back into contact with each other,similarly as shown in FIG. 18, which will return the movable fulcrum 122to a state where it is no longer impinging on the dental post pullingtool engaging end 80 of post remover tool 90. The user can next rotatethe movable fulcrum 122 so that it is screwed down into contact with thedental post pulling tool engaging end 80 of the pulling tool 90, andthen again activate the pulling tool 90 to further pull up the tubularstructure 100 and its attached dental post (not shown). This process canbe repeated until the post is freed from the tooth T. In practice,sometimes there is little or no movement of the dental post until itbreaks loose. Thus, the dental post remover tool 90 may need to beuntightened and reattached in different positions to aid in thisprocess.

Although the movable fulcrum 122 is described as having a threadedthrough hole 132 which threadably engages with the male threads 106 ofthe externally threaded region 104 of the tubular structure 100, meansother than threads can be used to change the position of the movablefulcrum 122 along the tubular structure 100. For example, the movablefulcrum can comprise a clamp with teeth that clamps onto complementaryteeth formed on the tubular structure, wherein once the clamp is inplace, it can only be moved further downwardly onto the tubularstructure but will not move rearwardly. The teeth of the clamp can bespring loaded so that they engage with the tubular structure 100 andlock in place so that the clamp will not be movable rearwardly but canbe pushed forwardly to contact a pulling tool.

Turning now to FIG. 22, there is shown a cross-sectional view of anotherembodiment of a continuously internally tapered tubular structure 300 ofa dental post removal device of the invention. The tubular structure 300does not show a fixing structure or a distal externally threaded regionas with previously described embodiments, but will have one of thesefeatures located above an upper end 302 of the tubular structure 300.The tubular structure 300 has a perimeter wall 304 with an outer surface306 and an inner surface 308. The tubular structure 300 has an outerdiameter OD. The outer surfaces of the tubular structure 300 definegenerally parallel walls, but the inner surfaces bevel inwardly from thetop 302 to the bottom opening 310, and the upper end 302 a larger innerdiameter IDU and the lower end 310 as a smaller diameter IDL. Thus, alumen 320 passing through the tubular structure 300 will be generallyinternally cone shaped, while the outside walls will remain parallel.Thus, the walls will be thicker near the lower end 310 and thinner nearthe upper end 302. This increased thickness at the open end providesgreater pull through strength that will help prevent the tubularstructure from possibly splitting. The inside surface of the walls aremade to be adhesive enhanced 312 by roughening the surfaces, applyingscratches, having a high adhesion coating, or even having inner threadsformed on the inside walls. Since most hedstrom files are right handthreaded, it is preferable to include right-hand inner threads in thetubular structure so that they will engage with the right-hand flutes onthe hedstrom file inserted into the lumen, and the hedstrom file engageswith the notches created in the post, in the same manner as shown in theembodiment of FIG. 16. Alternately, it is also possible to include lefthanded inner threads in the tubular structure so that they will engagewith the left-hand flutes on the hedstrom file inserted into the lumen.

FIG. 23 is a cross-sectional view of yet another embodiment of agraduated parallel sided internally stepped tubular structure 400 of adental post removal device of the invention. The tubular structure 400does not show a fixing structure or a distal externally threaded regionas with previously described embodiments, but will have one of thesefeatures located above an upper end 402 of the tubular structure 400.The tubular structure 400 has a perimeter wall 404 with an outer surface406 and inner surfaces 408A-D located in stepped sections SA-SD. Thetubular structure 400 has an outer diameter OD. In FIG. 23, four steppedsections S1, S2, S3, and S4 are shown, which have correspondingdecreasing inner diameters from ID1, ID2, ID3, to ID4, respectively. Theouter surface of the tubular structure 400 define generally parallelwalls 406, and the series of stepped sections S1, S2, S3, and S4 alsoeach have generally parallel walls, decreasing from a largest upperdiameter ID1 to a smallest diameter ID4 in section SD near the bottomopening 410. In lieu of the internal walls being generally parallel,they can also be angled relative to each other so that the steppedsections are generally cone-shaped. In any case, a lumen 420 passingthrough the tubular structure 400 will be in the form of a stepped cone,while the outside walls will remain parallel. Thus, the walls will bethicker near the lower end 410 and thinner near the upper end 402.Although four stepped sections S1, S2, S3, and S4 are shown, a lesser orgreater number of steps can be provided. In the transitions between thesections S1 and S2, S2 and S3, and S3 and S4, there are ledges 314A,314B, and 314C. The inside surface 416 of the walls 404 are made to beadhesive enhanced by roughening the surfaces, applying scratches, havinga high adhesion coating, or even having inner threads formed on theinside walls. This increased thickness at the open end provides greaterpull through strength that will help prevent the tubular structure frompossibly splitting.

Although embodiments of the present invention have been described indetail hereinabove in connection with certain exemplary embodiments, itshould be understood that the invention is not limited to the disclosedexemplary embodiments, but, on the contrary is intended to cover variousmodifications and/or equivalent arrangements included within the spiritand scope of the present invention.

What is claimed is:
 1. A dental post removal device, comprising: ahollow tubular structure having a sidewall and two open ends, andengaging features formed on the sidewall; and a movable fulcrum movablypositioned on the hollow tubular structure and adapted for pulling thehollow tubular structure, wherein the movable fulcrum comprises afulcrum body with a dome shaped front end that is adapted to seatprecisely into a depression on a post pulling tool, and a femalethreaded through hole that passes therethrough, which fulcrum body isadapted to screw onto complementary male threads formed on a distalouter section of the tubular structure.
 2. The dental post removaldevice of claim 1, wherein the engaging features comprise at least oneof a plurality of openings formed through the sidewall of the hollowtubular structure, and the inner wall surfaces of the sidewall are atleast one of scored, textured, dimpled, coated with a high adhesionmaterial or other type of surface preparation chemical, and/or internalthreads formed on the inside of the sidewalls, the engaging featuresbeing adapted to improve adhesion to a composite resin, cement and/oradhesives to be placed in the hollow tubular structure.
 3. The dentalpost removal device of claim 1, wherein the tubular structure is ofgenerally constant outer diameter except at a distal end thereof whichhas a wider diameter than the male threaded region of the tubularstructure.
 4. The dental post removal device of claim 3, wherein thedistal end of the tubular structure is one of mushroomed out and havingan enlarged ring on the distal end thereof.
 5. The dental post removaldevice of claim 1, wherein the hollow tubular structure is selected fromthe group of materials consisting of pliable metal, non-pliable metal,and/or composite materials.
 6. The dental post removal device of claim1, wherein the tubular structure is of generally constant outer diameterand has an inner diameter that continuously narrows from the distal endto the proximal end.
 7. The dental post removal device of claim 1,wherein the tubular structure is of generally constant outside diameterand has an inner diameter that narrows from the distal end to theproximal end in discrete stepped sections, wherein each stepped sectionhas generally parallel inner walls.
 8. A dental post removal kit,comprising a series of dental post removal devices, each devicecomprising: a hollow tubular structure having a sidewall and two openends, and engaging features formed on the sidewall; and a fulcrumpositioned onto the tubular structure and adapted for pulling the hollowtubular structure, wherein the movable fulcrum comprises a fulcrum bodywith a dome shaped front end that is adapted to seat precisely into adepression on a post pulling tool, and a female threaded through holethat passes therethrough, which fulcrum body is adapted to screw ontocomplementary male threads formed on a distal outer section of thetubular structure; wherein in the dental post removal kit, the pluralityof hollow tubular structures have a range of different internaldiameters.
 9. The dental post removal kit of claim 8, wherein theengaging features comprise at least one of a plurality of openingsformed through the sidewall of the hollow tubular structure, the innerwall surfaces of the sidewall being at least one of scored, textured,dimpled, coated with a high adhesion material or other type of surfacepreparation chemical, and/or the inside of the sidewalls beinginternally threaded, the engaging features being adapted to improveadhesion to a composite resin, cement and/or adhesives to be placed inthe hollow tubular structure.
 10. A dental post removal kit of claim 8,further comprising at least one of infill material comprising compositeresin, cement, and/or adhesive for infilling the hollow tubularstructure.
 11. A dental post removal kit of claim 10, further comprisinga series of aggressively-fluted endodontic files, such as Hedstromfiles, of various lengths and diameters which may be either left handthreaded or right hand threaded or a series of both left hand and righthand threaded files to be inserted via an open end of the tubularstructure and through infill material that is unset/unpolymerized. 12.The dental post removal kit of claim 8, wherein the hollow tubularstructure is formed of a group of materials consisting of pliable metal,non-pliable metal, composite materials, and/or other materials.
 13. Thedental post removal kit of claim 8, wherein each dental post removaldevice in the series of devices has its tubular structure of generallyconstant diameter.
 14. The dental post removal kit of claim 8, whereinthe tubular structure is of generally constant outer diameter except ata distal end thereof which has a wider diameter than the male threadedregion of the tubular structure.
 15. The dental post removal device ofclaim 8, wherein the tubular structure is of generally constant outsidediameter and has an inner diameter that continuously narrows from thedistal end to the proximal end.
 16. The dental post removal device ofclaim 8, wherein the tubular structure is of generally constant outsidediameter and has an inner diameter that narrows from the distal end tothe proximal end in discrete stepped sections, wherein each steppedsection has generally parallel inner walls.
 17. A dental post removaldevice, comprising: a hollow tubular structure having a sidewall and adistal open and a proximal open end, and engaging features formed on thesidewall; and a fulcrum positioned on the hollow tubular structure nearthe distal end and adapted for pulling the hollow tubular structure,wherein the fulcrum comprises a fulcrum body with a front end that isadapted to seat precisely into a depression on a post pulling tool, anda female threaded through hole that passes therethrough, which fulcrumbody is adapted to screw onto complementary male threads formed on adistal outer section of the tubular structure to adjust its distancerelative to the proximal open end of the tubular structure.
 18. Thedental post removal device of claim 17, wherein the engaging featurescomprise at least one of a plurality of openings formed through thesidewall of the hollow tubular structure, and the inner wall surfaces ofthe sidewall are at least one of scored, textured, dimpled, coated witha high adhesion material or other type of surface preparation chemical,and/or internal threads formed on the inside of the sidewalls, theengaging features being adapted to improve adhesion to a compositeresin, cement and/or adhesives to be placed in the hollow tubularstructure.
 19. The dental post removal device of claim 17, wherein thetubular structure is of generally constant outside diameter and has aninner diameter that continuously narrows from the distal end to theproximal end.
 20. The dental post removal device of claim 17, whereinthe tubular structure is of generally constant outside diameter and hasan inner diameter that narrows from the distal end to the proximal endin discrete stepped sections, wherein each stepped section has generallyparallel inner walls.